Sugar consumption from sugar-sweetened beverages (SSBs) now globally exceeds the recommended limit. With multiple studies linking high added sugar intake to increased risk of chronic diseases and mortality, including type 2 diabetes (T2D), it is important to gather an abundance of data to examine this association. Additionally, beverages that are artificially sweetened (ASBs) have commonly replaced SSBs; however, the link to adverse health outcomes, including T2D is not as well known. This study aimed to assess the association of SSBs and ASBs with risk of T2D. The Melbourne Collaborative Cohort Study (MCCS) examined 36,608 participants ages 40-69 years old for self-reported information about diabetes and frequency of consumption of SSBs and ASBs. Frequency was categorized as: never or < 1 time/month; 1-3 per month; 1-6 times per week; ≥ 1 time/day. Regression was used to determine association between intake and incidence of T2M, adjusting for lifestyle (Diet via a food frequency questionnaire and calculation of diet quality via Healthy Eating Index), obesity (BMI and waist and hip circumference), socioeconomic status, and other potential confounding factors.
Those with higher SSB consumption had higher BMI, central obesity, total energy and sugar intake, more likely to be male, have lower socioeconomic status, smoke and be less physically active, and more likely to drink ASBs and have lower diet quality. Those who consumed ASBs more frequently also had higher BMI, central obesity, total energy and sugar intake, and likely to have low socioeconomic status. They were more likely to be female, smoke and be less physically active, have lower diet quality, and less likely to consume SSBs.
Additionally, there was a 23% higher risk of T2M with higher intakes of SSBs (≥ 1 time/day; p=0.006). Similarly, there was an 83% increase in risk of T2M with higher intakes of ASBs (≥ 1 time/day; p<0.001). The association between SSB and T2M disappeared after adjusting for BMI and central obesity, but the association with ASB intake remained. These findings indicate that both SSB and ASB were linked to increased risk of T2M, which suggests the need for larger, more controlled studies to look at casual effects and potential mechanistic causes to then lead to public health initiatives and policies to help reduce intake of sweetened beverages.
Kabthymer RH, Wu T, Beigrezaei S, Franco OH, Hodge AM, de Courten B. The association of sweetened beverage intake with risk of type 2 diabetes in an Australian population: A longitudinal study. Diabetes Metab. (2025 Nov);51(6):101665. doi: 10.1016/j.diabet.2025.101665. Epub 2025 May 16. PMID: 40383372.